The Impact of COVID-19 Outbreak On Quality of Life, Seizure Frequency, Depression, and Anxiety in Patients with Epilepsy: A Cross-Sectional Study During the Early Period

INTRODUCTION:Epilepsy, according to our current knowledge, does not increase the risk of Coronavirus disease 2019 (COVID-19) infection or the rate of complications related to this infection. However, the COVID-19 pandemic can have adverse effects on patients with epilepsy (PWE) and affect the mental health of the community in general. This study aimed to evaluate the depression and anxiety of epilepsy patients, the effect of the epidemic on the frequency of seizures, and the quality of life of the patients in the past 3 months during the pandemic.METHODS:The patients who were referred to an epilepsy outpatient clinic of a tertiary neuropsychiatry center within the past 2 years were retrospectively evaluated. The data regarding the seizures, quality of life, anxiety, and depression were recorded during follow-up or through an online platform. Seizure frequency, frequency change during the pandemic (April 2020 to June 2020), medications, admissions were obtained, and Beck Depression and Anxiety Scale were applied to the patients. The patients’ quality of life was evaluated using the “Quality of Life Scale Short Form-36 (SF-36)” form.RESULTS:One hundred sixty-four patients (77 men, 87 women) included in the study were analyzed. The median overall seizure frequency and seizure frequency during pandemic were 0.2 seizures/month (0–1) and 0 seizures/month (0–0.9), respectively. 125(76.2%) of the patients reported that they had no seizures during that period. No significant difference was found between the frequency of seizures reported by the patients before and during the pandemic period (p=0.12). Only one patient had a PCR confirmed COVID-19 diagnosis, and the other six patients were diagnosed clinically and radiologically. No significant relationship was found between COVID-19 diagnosis and seizure frequency (p=0.671). 105(64.02%) patients were considered to have depressive symptoms with ten or more points according to the Beck Depression Scale. 116 patients (70.7%) were considered to have anxiety symptoms with nine or more points from the Beck Anxiety Scale.DISCUSSION AND CONCLUSION:This study was conducted to evaluate the seizure frequency, psychiatric status, and quality of life of PWE in April, May, and June 2020 during the first peak of the COVID-19 pandemic in our country while the social restrictions were applied at the highest level. We found that there was no significant increase in the seizure frequency of patients during the pandemic period and depressive symptoms were common in this patient group and affected their quality of life

Reliability and validity of the Cambridge Worry Scale in pregnant Turkish women

Objective: this study examined the psychometric properties of the Cambridge Worry Scale (CWS) and assessed worries in pregnant Turkish women

Short-Term Results of Vagal Nerve Stimulation in Resistant Epilepsy Patients

Objectives:Vagal nerve stimulation (VNS) is an appropriate treatment option for refractory patients who are not eligible for resective epilepsy surgery. In this study, the clinical and demographic characteristics of VNS patients were documented and it was aimed to determine the effect of VNS on seizure control.Methods:A retrospective survey was performed for patients who were diagnosed as drug resistant epilepsy and underwent VNS implantation, with at least 1 year of follow-up. Nine patients (eight males and one female) with an average age of 30.11 (18–42), were included. Reduction in seizure frequency prior and in the 3rd, 6th, and 12th months after VNS implantation was compared. Patients were considered responders when a reduction of seizures of more than 50% was reported.Results:The mean time from the onset of the disease to VNS implantation was 17.33±9.75 years and the mean age when VNS was implanted was 24.53 (9–39). Decrease in frequency of seizures from VNS implantation to 3 months and 6 months was statistically significant (p=0.003 and p=0.012, respectively). No statistical significance was found between the frequency of seizures before treatment and at the 12th month (p=0.153).Conclusion:In our study, we observed a decrease in seizure frequency in patients with drug resistant epilepsy with a variety of etiologies, which was similar with the literature data. Although a cumulative effect was reported, we have observed a minimal decrease in frequency after the 3rd month

THE HEALTH COMPLAINTS OF WHITE COLLAR WORKERS AND INDOOR AIR QUALITY IN NON-INDUSTRIAL WORKPLACES

Objective: Sick building syndrome (SBS) with the symptoms, such as ocular and shin impairments, upper 3 respiratory infections, focusing problems, headache and fatigue, and causing anxiety in employees is seen as a widespread public health problem in the modern office environments. In this study, we aimed to evaluate environmental risk factors in the indoor air and their impacts on the employees' health and to discuss solution offers in non-industrial workplaces

Vacuolating Megalencephalic Leukoencephalopathy with Subcortical Cysts (Van der Knaap Leukoencephalopathy): A Case Diagnosed in Adulthood

Van der Knaap leukoencephalopathy is a rare vacuolating megalencephalic leukoencephalopathy with subcortical cysts. It is inherited autosomal recessively with MLC1 and GlialCAM mutations. The disease is usually diagnosed in the patient's first years of childhood and symptoms are severe in adulthood. In this case, a male patient aged 35 years presented with pathologic cerebellar and pyramidal findings. Magnetic resonance imaging revealed bilateral cystic degeneration in the anterior temporal lobes, swelling in the supratentorial white matter, and abnormal signal. There were no pathologic findings in the differential diagnosis tests. The patient was diagnosed as having Van der Knaap leukoencephalopathy according to the clinical and radiologic findings

Association of MDR1 (C3435T) polymorphism and resistance to carbamazepine in epileptic patients from turkey

Background and Aims: We investigated the prevalence of this multidrug resistance 1 gene (MDR1) polymorphism in drug-responsive versus drug-resistant epilepsy patients treated with carbamazepine (CBZ), which is a substrate of this protein. Methods: We genotyped the C3435T variant of MDR1 in 97 patients treated with CBZ monotherapy who had been on stable doses for more than 1 month. Our control group included 174 healthy individuals. Plasma CBZ concentrations were also measured using fluorescence polarization immunoassay. Results: We could not demonstrate any statistically significant relationship with the genotypes among drug-resistant patients (n = 44). The frequency of the homozygous mutant (TT) genotype was 15% in drug-responsive patients, 11.3% in drug-resistant patients and 25.8% in the control group. We also did not observe any significant correlation between the presence of a specific allele and CBZ plasma level/dose index. Conclusion: Our study did not support any significant association between the MDR1 (C3435T) polymorphism and resistance to CBZ in epilepsy patients from Turkey. Copyright (C) 2007 S. Karger AG, Basel

Ischemic modified albumin increases in acute kidney injury

Purpose: Acute kidney injury (AKI) is a severe kidney disease carrying high morbidity and mortality. An ischemic process, at the cellular level, has been detected prior to the full-blown AKI. An elevated ischemic modified albumin (IMA) was also found to be increased fast at several minutes following an ischemic process in the body. In this connection, we have investigated, in advance, the changes of IMA concentrations in patients with possible AKI. Methods: IMA and other biochemical and haematological parameters were measured in sera of thirty nine patients with AKI and of thirty eight healthy controls. AKI is defined by an increase in serum creatinine by ≥ 0.3 mg/dl in 48 hours or an increase by ≥ 1.5-fold from a known or assumed baseline. The results in the two groups were compared. Results: IMA, creatinine, blood urea nitrogen, white blood cell, neutrophil, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and mean platelet volume were found to be higher in patients with AKI than in healthy controls. In contrast, total protein, albumin, lymphocyte, and haemoglobin were lower in patients with AKI than in healthy controls. No significant difference was recorded in platelet counts between the two groups. Conclusion: Our results indicate that increased levels of NLR and PLR play a central role in a systemic inflammation in AKI. Monitoring serum IMA could be a useful tool in the assessment of AKI

Pregnancy and Epilepsy: Clinical Data and Adverse Outcomes of Pregnant Women with Epilepsy

Objectives:Pregnancy in women with epilepsy carries a higher risk for fetal development complications, including congenital malformations. In this study, data obtained from pregnant epilepsy patients in a tertiary epilepsy center were presented.Methods:In this study, 128 pregnancies of 110 pregnant women followed up in the epilepsy outpatient clinic between April 2011 and April 2021 were examined. Demographic data of the patients, antiepileptic drugs AEDs used, and pregnancy outcomes were reviewed retrospectively.Results:During pregnancy, 101 patients (78.9%) received monotherapy, and lamotrigine was the most commonly used drug in monotherapy. A two-drug combination was used in 18 patients (14.1%), and a three-drug combination was used in 5 patients (3.9%). Although the frequency of seizures did not increase in most patients, the frequency of seizures increased in 18 patients (14.1%) and decreased in 5 patients (3.9%). In our study, the intrauterine fetal loss occurred in five patients, newborn infants with congenital malformations in three patients, and neonatal death during delivery in one patient. The number of AEDs used in multivariate logistic regression predicted adverse outcomes such as intrauterine fetal loss, neonatal death, and newborns with congenital malformations.Conclusion:Management of pregnant patients with epilepsy is difficult for both mother and fetus. In our study, combination therapy was more associated with adverse outcomes for the fetus and newborn. Pregnancy should be planned, and seizure-free pregnancy should be targeted with low-dose monotherapy

Ictal singing due to left mesial temporal sclerosis

Simple ictal or interictal automatisms are commonly seen in epilepsy, whereas complex automatisms are rare. Simple ictal vocalizations or appendicular automatisms have been reported to be due to mesial temporal lobe epilepsy. However, seizure-associated singing and dancing is very rare. We report a seventeen-year-old patient with ictal singing and rhythmic swinging of the arms as a dancing gesture. The video-EEG recording showed ictal left temporal lateralization and neuropathology confirmed left mesial temporal sclerosis